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Sunday, September 30, 2012

Health
Care Reform and the Presidential Candidates

September
30, 2012 -The September 26 issue of New England Journal of Medicine contains
these statements by President Obama and Governor Romney on their positions and
visions of health reform.The
statements are directed to physicians,59% of whom are pessimistic about
the future of the health system and 92%
of whom are unsure about the future or where they will fit in over the next
five years according the Physicians Foundation national survey of 630,000 physicians,which was released on September 24.

Securing
the Future
of American Health Care

President
Barack Obama

From the
moment I took office, the central challenge we have confronted as a nation has
been to recover and rebuild from the worst economic crisis since the Great Depression.
We’ve taken extraordinary steps to repair the immediate damage and lay the
foundation for an economy built to last. And a critical first step on this
journey has been taking action to restore health care as a basic pillar of
middle-class security.

Because of
you, America is blessed with the world’s most talented health care
professionals, who do a heroic job serving and saving our citizens. But for
years you have faced a health care system that was increasingly fractured.
Insurance companies had unchecked power to dictate care and cap and cancel your
patients’ in-surance. Tens of millions of Americans were left uninsured and
underinsured. Health carecosts were growing at an unsustainable rate, and our
delivery system rewarded quantity of care over quality of care. You were
spending more of your time on insurance forms and appeal letters — and less
time doing what you trained to do: care for patients. But after a century of
trying, a broad coalition of doctors, nurses, hospitals, businesses, AARP, and
patients helped me sign into law the Affordable Care Act.

Supporters
and detractors alike refer to the law as Obamacare. I don’t mind, because I do
care. And because of Obamacare we’re moving forward toward a health care system
that broadly provides health security.

For the
majority of Americans who get health insurance through their employer, the law
won’t change that, but it will make their coverage more secure and affordable.
Today, 105 million people have seen a lifetime cap on their coverage lifted, so
your patients no longer face the tragedy of approaching a lifetime limit in the
middle of a round of chemotherapy or an episode in the ICU. Most of your
patients can now get preventive care without paying deductibles and copays,
care that you know saves lives, from early colon- and breast-cancer screenings
to cardiovascular tests and flu shots. Because of new limits on insurance
overhead costs, 13 million Americans got more than $1 billion in rebates — and
by 2019, economists believe, family premiums will be about $2,000 less.

The law
also roots out waste and fraud in Medicare and Medicaid, gets rid of insurance
overpayments, reinvests those savings back into the sys- tem, and adds 8 years
to the solvency of Medicare. Obamacare is closing the Medicare doughnut hole —
saving people an average of $600 last year — and bolstering your efforts to get
your patients to adhere to their medications. More than 3 millionyoung adults
who would otherwise be uninsured have coverage on their parents’ plan until
they are 26 years old, and up to 17 million children with preexisting
conditions are no longer at risk of being denied coverage. Small-business
owners are getting tax credits to provide coverage for their workers and will soon
be able to pool together to leverage better rates, just like big corporations.

As you
surely experience every day, we are also seeing substantial movement in the
emergence of new care models. Everyone understands the limits of our current
system, which rewards increases in the quantity of care, not improvements in
the quality. Still, change has been difficult — and that’s why my
administration has been so encouraged by the response to the reforms in the
health care law. Across the country, provider groups are working with us to
form accountable care organizations, and more and more hospitals are moving
toward bundled payments. We are partnering with hospitals across the country to
prevent health care–associated infections and avoid preventable readmissions
—and meeting our goals together could save $35 billion and 60,000 lives over 3
years. And we are building our health care workforce, recognizing the demands
of an aging population as well as the needs of peo-ple who will become newly
insured. As we move forward, we will remain a partner in working to-gether to
strengthen our system and help you de-liver the best possible care.

Of course,
there is more to come, since many of the law’s provisions take effect in 2014,
when 30 million currently uninsured people will finally begin to find
affordable coverage. Our insurance market will be strengthened so insurance
compa-nies cannot deny coverage or charge anyone more on the basis of a
preexisting condition, and middle-class families that don’t get insurance at
work can receive tax credits to finally make coverage affordable. As a result,
for the first time in American history, people who lose their jobs, change
jobs, start a business, or retire early will know that they can find insurance
for themselves and their families.

If I am
elected for a second term, I will follow through on all the work we have
started together to implement the Affordable Care Act. I have also been clear
that additional steps are needed. We need a permanent fix to Medicare’s flawed
payment formula that
threatens physicians’ reimbursement, rather than the temporary measures that
Congress continues to send to my desk. I support medical malpractice reform to
prevent needless lawsuits without placing arbitrary caps that do nothing to
lower the cost of care. NOT A PRAYER I also know we must continue to support
life-sciences research and ensure that our regulatory system helps bring new
treatments and tools to pharmacies, doctors’ offices, and hospitals across the
country. I will keep Medicare and Medicaid strong, working to make the programs
more efficient without undermining the fundamental guarantees.

My
opponent in this election, Mitt Romney, has a radically different vision for
the future of our health care system — even if it means running from his past
as the architect of health reform in Massachusetts. He would begin by repealing
Obamacare on day 1. Your patients would once again be charged excessive copays
for preventive care, and millions of Americans would be one illness or injury
away from bankruptcy. He would undo the progress we are making toward a more
coordinated delivery system.

Romney and
his running mate, Congressman Paul Ryan, have proposed a budget that could
force drastic cuts to investment in medi- cal research, eliminating 1600
National Institutes of Health grants and slowing our progress on scien- tific
and medical breakthroughs. They have pledged to turn Medicaid into a block
grant and slash its funding by a third — plunging tens of millions more
Americans into the ranks of the uninsured and leaving our hospitals and health
care providers to grapple with an increasing burden of uncompensated care. And
they are committed to ending Medicare as we know it by turning it into a
voucher program, with insurance companies set to make millions while seniors
and people with disabilities are forced to pay thousands more every year.

This
election offers a fundamental choice between those two very different visions
for the future of our country. Although the debate over Obamacare has been
divisive, I signed the legislation not because it was good politics, but
because it was good for the country. It enshrines a core principle that makes
us who we are as Americans: that everybody should have some basic security when
it comes to their health care.

We will
implement the law and work together to improve where we can. But our country
simply can’t afford to refight old political battles, reopen old wounds, and
return to the way things were. We are a nation that does what is hard and what
is necessary and what is right. And we will be better off 5, 10, 20 years from
now because we had the courage and foresight to keep moving forward.

Replacing
Obamacare with Real Health Care Reform

Governor
Mitt Romney

Health
care is at once among our nation’s greatest strengths and most serious
challenges. People come from around the world to receive treatment in America’s
top medical centers, yet too many of our own citizens have difficulty gaining
access to basic services. No issue is of deeper or more personal concern than
guaranteeing the health of our loved ones. No American should ever have to fear
being left uncared for in the middle of the world’s most advanced health care
system.

Unfortunately,
our challenges grow worse every year. Higher premiums cut sharply into
paychecks that never seem to increase. Losing a job means losing insurance
cover- age at the moment a family can least afford it, and those with
preexisting conditions can be left with nowhere to turn, despite needing the
greatest care. The sheer volume of red tape overwhelms eventhe most savvy
consumers, while taking too much of each doctor’s time and slowing innovation
in life sciences. Through it all, experts continue to warn that the current
path is unsustainable — that for all its frustrations, the system is becoming
more expensive and will eventually bankrupt our government.

President
Obama’s 2700-page federal takeover does not solve our problems. His $1 trillion
in tax increases hits the middle class hard and drives medical innovation
overseas. His $700 billion in Medicare cuts “will not be viable,” according to
the program’s trustees, jeopardizing access to care for senior citizens and
throwing millions of beneficiaries off the coverage they rely on. Millions of
other Americans who were told they could keep their coverage will lose it, and
more than one third of new coverage will come through the dramatic expansion of
a broken Medicaid system.

After all
this, his plan still fails to control costs (according to Medicare’s chief
actuary) or to provide a long-term solution to the nation’s entitlement crisis
(according to the Treasury Secretary), so he leaves those tasks to a board of
15 unelected bureaucrats empowered to sidestep Congress and impose drastic
cuts.

If elected
President, I will repeal Obamacare and replace it — not with another massive
federal bill that purports to solve all our problems from Wash-ington, but with
common-sense, patient-centered reforms suited to the challenges we face.

In the
health care system that I envision, costs will be brought under control not
because a board of bureaucrats decrees it but because everyone —providers,
insurers, and patients — has incentives to do it. Families will have the option
of keeping their employer-sponsored coverage, but they will also be empowered
to enjoy the greater choice, portability, and security of purchasing their own
insurance plans. As a result, they will be price-sensitive, quality- conscious,
and able to seek out the features they want. Insurers will have to compete for
their business. And providers will find themselves operating in a context where
cost and price finally matter. Competition among providers and choice among
consumers has always been the formula for better quality at lower cost, and it
can succeed in health care as well.

To achieve
this aim, we must end tax discrimination against persons purchasing insurance,
we must strengthen and expand health savings accounts, and we must establish
strong consumer protections. The result will be patients who can confidently
choose the coverage that is right for them, who know and care what health care
costs, and who re- ward providers that deliver effectively. For this choice to
be meaningful, insurance market reforms must promote competition by eliminating
onerous man- dates, facilitating purchasing pools, and opening up an interstate
market. Regulation must prevent insurers from discriminating against people
with preexisting conditions who maintain continuous coverage.

A
strengthened system must also be one where America continues to lead the world
in innovation and where we continue to attract the best and the brightest, both
from our own towns and from around the world, to the practice of medicine.
Doctors should spend more time treating patients and less time practicing
defensive medicine or processing paperwork.

Innovators
should increase their investments in new cures, and those cures should reach
the market faster.

Achieving
these goals requires medical malpractice reform, a streamlined regulatory
framework to support the interoperability of information technology, and strong
Food and Drug Administration leadership committed to a practical and
predictable approval process that appropriately evaluates risk.

Finally,
for our health care system to work for all Americans, we must have government
programs that effectively serve our senior citizens and people in need without
breaking the bank. In other words, we need genuine entitlement reform.

I will
make no changes to Medicare for those enrolled in the program today or
enrolling during the next 10 years. For younger Americans, I will implement a
system similar to that used by members of
Congress. Future beneficiaries will have a set of Medicare-approved,
guaranteed-coverage plans to choose from, including today’s traditional fee-for-service
option. Plans will participate in a competitive bidding process to establish
the premiums they will charge, as they do in the Medicare prescription drug
plan that has so effectively controlled cost.

The
government will then provide premium support, set relative to the competitively
bid premiums and made more generous for the poor and the sick than for the
wealthy, which ensures that each beneficiary can afford high-quality coverage.
This approach will guarantee senior citizens the financial support and
high-quality care they deserve while relying on competition and choice — not
bureaucrats — to deliver significant savings.

Nor can
our society ever turn its back on those who cannot afford the care they need.
We will provide support for low-income Americans and those uninsured persons
whose preexisting conditions push the cost of coverage too high for them to pay
themselves. But my experience as a governor and the lessons from the
President’s attempt at a one-size-fits-all national solution convince me that
it is states — not Washington — that should lead this effort.

I will
convert Medicaid into a block grant that properly aligns each state’s
incentives around using resources efficiently. Each state will have the
flexibility to craft programs that most effectively address its challenges — as
I did in Massachusetts, where we got 98% of our residents insured without
raising taxes.

Everyone
can agree on the goal of health care reform: ensuring affordable access to
high-quality care for all Americans. The question is how. Whenever President
Obama claims that only Obamacare helps those with preexisting conditions, I am
reminded of the woman in Iowa who found affordable coverage in a high-risk pool
despite a preexisting condition.

The
President’s campaign took credit, but as it turned out, the high-risk pool
created by Obamacare had actually turned her away . . . at which point she
discovered that her state already offered a high-risk pool that met her needs.
Whenever he claims that only Obamacare helps those under the age of 26 stay on
their parents’ insurance, I am reminded that some of our nation’s largest
insurers have already announced they would offerhis option
regardless of what the law requires . . . because they are responding to
consumer demands in the market.

President
Obama believes the answer lies in a bigger government that decides what care
Americans should receive and how much providers should be paid for it.

But his
plan has already failed to deliver on virtually every promise he made, and its
components are failing as quickly as they go into effect. It must be repealed.
I believe the answer lies with patients and families, with reformed insurance
markets and fair competition, with strong consumer protections and real
entitlement reform.

My plan
tackles our health care challenges without a federal takeover of the entire
system. Instead, it relies on markets over regulations, doctors and patients
over bureaucrats, and tailored state programs over a 2700-page “solution” from
Washington. Tweet: President Obama proposes to keep on implementing his health care law as it; Governor Romney would repeal the law and rely on market reform.

I believe that the key statistics, quoted
directly from the report below, clearly show that the U.S. healthcare system,
which has become increasingly out of control year after year for decades, is in
real danger of collapse, and that the Affordable Care Act is more the last
straw than culprit.

James Doulgeris, “New
Survey Validates That U.S. Physicians Are Ailing”, Physicians Practice, September 27, 2012. Doulgeris is referring to the Physicians Foundation Survey.

September 29, 2012 – I do not like what I
see may be coming – the collapse of the U.S. health system as the physician
shortage intensifies and escalates and as the business community begins to withdraw coverage.

My
evidence for this dommsday scenario is personal, and it is skimpy.In the last 11 days, as I have posted these
7 reports on this blog, 4 of them related to the Physicians Foundation survey of
630,000 U.S. physicians and 3 of them to the collapse of confidence
in the health system, the number of readers of my blog has doubled then tripled.

·September 17, Crisis of Confidence in Health System

·September 22, Revenge of the EHR Nerds

·September 24, Physician Foundation Survey of 630,000 Physicians

·September 27, Obamacare and Innovation

·September 27, Physician Morale at All Time Low

·September 28, Obamacare, Business, and the Law of Unintended
Consequences

·September 28, New Study Validates That U.S. Physicians are
Ailing

The
common denominator of these posts is that the physician and business
communities, with mounting evidence of uncontrolled costs and the dampening
effects of federal regulations, have lost faith in the health law to provide
affordable access to care to more Americans.

As
a result, physicians are pulling out of private practice, the physician shortage
is intensifying, businesses are dropping coverage, and higher costs are shifting to
health consumers.

So
how does one turn around the Health System Titanic?What do American physicians, who care for all
Americans, and American businessmen, who cover 160 million Americans, want?
I do not presume to talk for American business, but I believe I know what
American physicians want.

Physicians
want:

·To be treated as medical professionals, rather than serfs and wards of the
federal government.

·To be trusted to do the right thing at the right time for the
right reasons – for patients, rather than for their own self-interest.

·To practice medicine, rather to serve as data entry clerks.

·To have regulations reduced, so that they have do not have to
hire a staff of 4 or 5 to comply with documentation demands.

·To have services paid for on the basis of skill and time spent with
patients, rather than by a labyrinthic coding system with 7500 codes created the AMA and CMS.

·To have a liability system, with rational and just awards for medical
injuries, rather than the present open-ended casino system which forces them to practice defensive medicine.

·To be able to maintain a private practice rather than a system
that forces them to become employees of large institutions to fulfill administrative functions.

·To practice in a system with administrative simplicity and transparency
that is clear to doctors and patients.

·To be paid reasonable fees by alternative means – phone, email, online consultation,
and Skype or by covering a defined population – rather than to always have the physical presence of the patients.

·To have the freedom and latitude without endless second-guessing to do what is right for the
patients rather than what feeds the bottom line of government and health plans.

·To have the public realize that health costs do not stem from
doctors alone and that government and health plans, not physicians,set most physician fees and generate many of the costs.

·To permit physicians and patients to agree to have contracts
outside of Medicare if the physicians and patients so agree.

·To make the medical profession attractive again, so that it
attracts the best and brightest among us.

Tweet:If surveys and actions of physicians and the
business community are any indication, the U.S. health system may be on the
verge of collapse.

Friday, September 28, 2012

New Survey Validates That US Physicians
are Ailing

By James Doulgeris
|September 27, 2012

In the largest survey
of its type since one conducted by the Doctor Patient Medical Association a few
months back, an even more extensive survey by the Physicians Foundation that
generated 13,575 responses from practicing physicians is equally sobering.

The survey was
conducted by the recruiting and consulting firm Merritt Hawkins in an e-mail
containing 48 questions to 630,000 physicians in active care, 8,000 of which
included comments by the respondents ranging from positive to defeated. I
believe that the key statistics, quoted directly from the report below, clearly
show that the U.S. healthcare system, which has become increasingly out of
control year after year for decades, is in real danger of collapse, and that
the Affordable Care Act is more the last straw than culprit

Conclusions verbatim
from the report:

KEY FINDINGS

Responses to the
survey combined with some 8,000 written comments submitted by physicians
reflect a high level of disillusionment among doctors regarding the medical
practice environment and the current state of the healthcare system. How
physicians will respond to ongoing changes now transforming healthcare delivery
varies. Many physicians plan to continue practicing the way they are, but over
half of physicians surveyed have reached a tipping point and plan to make
changes to their practices. Many intend to take one or more steps likely to
reduce patient access to their services, limiting physician availability at a
time when doctors already are in short supply.

Key findings of the
survey include:

Over three quarters of
physicians — 77.4 percent — are somewhat pessimistic or very pessimistic about
the future of the medical profession.

Over 84 percent of
physicians agree that the medical profession is in decline.

The majority of
physicians — 57.9 percent — would not recommend medicine as a career to their
children or other young people.

Over one third of
physicians would not choose medicine if they had their careers to do over.

Physicians are working
5.9 percent fewer hours than they did in 2008, resulting in a loss of 44,250
full-time-equivalents (FTEs) from the physician workforce.

Physicians are seeing
16.6 percent fewer patients per day than they did in 2008, a decline that
could lead to tens of millions of fewer patients seen per year.

Physicians spend over
22 percent of their time on non-clinical paperwork, resulting in a loss of some
165,000 FTEs.

Over 60 percent of
physicians would retire today if they had the means.

Physicians are not
uniform in their opinions — younger physicians, female physicians, employed
physicians and primary-care physicians are generally more positive about their
profession than older physicians, male physicians, practice owners, and
specialists.

Over 52 percent of
physicians have limited the access Medicare patients have to their practices or
are planning to do so.

Over 26 percent of
physicians have closed their practices to Medicaid patients.

In the next one year
to three years, over 50 percent of physicians plan to cut back on patients,
work part-time, switch to concierge medicine, retire, or take other steps that
would reduce patient access to their services.

Over 59 percent of
physicians indicate passage of the Patient Protection and Affordable Care Act
(i.e., “health reform”) has made them less positive about the future of
healthcare in America.

Over 82 percent of
physicians believe doctors have little ability to change the healthcare system.

Close to 92 percent of
physicians are unsure where the health system will be or how they will fit into
it three to five years from now.

Over 62 percent of
physicians said Accountable Care Organizations (ACOs) are either unlikely to
increase healthcare quality and decrease costs or that that any quality/cost
gains will not be worth the effort.

Physicians are divided
on the efficacy of medical homes, and many (37.9 percent) remain uncertain
about their structure and purpose.

Over 47 percent have
significant concerns that EMR poses a risk to patient privacy

Over 62 percent of
physicians estimate they provide $25,000 or more each year in uncompensated
care.

September
28, 2012 -There used to be game show
called “Truth or Consequences.”If you
believe the truth unintended consequences are at work in the health care law, passed by Congress. Even the bulk of the law does not kick in until 2014, the present consequences include:

·Raising costs of family coverage by $2500
instead of lowering costs by $2500 as promised.

·
Motivating employers to postpone hiring until
they have a clear picture of the economic consequences of Obamacare.

·Creating incentives for at least 10% of employers
to drop coverage as a less expensive alternative than paying the penalty for
not offering coverage.

·Leading many large employers and insurers to
change coverage tovoucher-type system
where workers are given a set amount to money and told to shop for the best
deal.

·Driving private practitioners, who are essentially small businessmen, into the arms of hospital employers, because the doctors can no
longer afford to care for Medicare and Medicaid patients.

·Burdening taxpayers with more than $510
billion in new taxes directly or indirectly related to Obamacare

Antagonizing small and large businesses through heavy regulations and increased costs of doing business and offering health insurance to emplpyees, which is why the Chamber of Commerce,The National Federation of Independent Businesses, and other business organizations oppose Obamacare.

·Taxing the medical device industry with a
2.3% tax on sales of devices, which amounts to a 15% tax on profits.

Of
the medical device tax, Evan Bayh, former Democratic Senator from Indiana,has this to say:

“The Supreme Court decision in June upholding the
Affordable Care Act leaves in place a tax on medical devices that threatens
thousands of American jobs and our global competitiveness. It will also stifle
critical medical innovation in the industry that gave us defibrillators,
pacemakers, artificial joints, stents, chemotherapy delivery systems and almost
every device we depend on to save lives.”

“The
2.3% tax will be charged to manufacturers on each sale and takes effect in
January. Many U.S. device companies, in response, have already announced
layoffs, canceled plans for domestic expansion and slashed
research-and-development budgets. This month, Welch Allyn—a maker of
stethoscopes and blood-pressure cuffs—announced that it will lay off 10% of its
global workforce over the next three years, but all of the jobs being cut are
in the U.S.”

“The
medical-device industry has been a great American success story. More than
400,000 U.S. workers are employed in this sector directly, and another two
million, including those involved in supply and distribution, benefit
indirectly. At a time when the economy struggles to produce good jobs,
medical-device positions pay well. Average compensation is $58,188 annually
compared with a national average of $41,673 annually for all employment, a 2010
Pew Foundation report found.”

“Especially
hard hit could be the hundreds of small companies developing medical software
applications. These apps promise to revolutionize the practice of medicine—for
instance, by delivering blood-sugar test results for diabetics. The IRS is
deciding now whether to treat apps as medical devices subject to the tax.”

“The
adverse effect of this confiscatory level of taxation on traditional device
makers is already clear. In my state of Indiana alone, Cook Medical has
canceled plans to build one new U.S. facility annually in each of the next
several years, and Zimmer plans to lay off 450 workers, while Hill-Rom expects
to lay off 200. Stryker, based in Michigan, anticipates having to lay off 1,000
workers.”

Tweet:Obamacare and regulations and taxes it
imposes threatens vitality, innovation, and profitability of businesses and medical pratices.

Thursday, September 27, 2012

Software
to Increase Physician Morale By Increasing Efficiency

Every physician has a favorite
innovation.

Anonymous

September
27, 2012 -Lately I’ve been writing posts
on loss of physician morale.Why the loss?Because physicians can’t keep upwith escalating federal
regulations, including meeting demands of new ICD-10 coding, qualifying for EHR
meaningful use criteria,getting paid
for the right codes, worrying about getting sued by patients or the government
for non-compliance, and handling the low reimbursements ofnew Medicaid and Medicare patients.Physicians are so distracted they no longer
have time to deal with quality care or spending quality time with patients.

So what
can physicians do?They can do three
things.

One, go to work for the hospital or
large health organizations who can handle the administrative or liability
paperwork require to function in the brave new world of health reform.

Two, drop out of regulated 3rd party medicine, by converting
to concierge medicine,cash-only practices, or do locum tenens.

Three, find some innovative solution
that allows them to stay in private practice, make a living, avoid malpractice,
become more efficient and productive, engages patients in such a way to draw
upon their unique knowledge, and practice quality medicine.

My Favorite Innovation

My
favorite medical innovation is the Instant Medical History, which I have been
following for ten years and which I highlighted in my 2007 book
Innovation-Driven Health Care, The Instant Medical History is now being used by more than 10,000
physicians to facilitate their practices.

Here is
how the company describes their Instant Medical History product.

“Branching logic enables patients to
progress quickly through adjustable questionnaires from an extensive medical
knowledgebase. Sophisticated technology enables this information to transfer to
EMRs. Physician productivity increases because as much as sixty percent of the
medical data necessary to complete the visit note can be provided by patients
and automatically documented in medical terminology through the Internet, in
exam rooms, or in waiting areas before the visit.”

We are the leading provider of patient
interviewing technology.

“Our vision is to become an
indispensable part of the way patients and physicians communicate. Our
solutions are used by physicians each day to facilitate physician-patient
communication in a variety of practice settings. Our software has been
recognized by vendor associations, consultants, and industry peers as an
invaluable component of medical history software and the future of healthcare."

What does the Instant Medical
History software accomplish?

1)It engages the patient directly, by
drawing on their knowledge, their complaint, their symptoms, and their family
and social history.

2)It satisfies the patient,who now has the satisfaction of knowinghis/her story is being considered
comprehensively from their point of view.

3)It efficiently combines theart of medicinewith data
made possible by modern information
technology.

4)It is practical and workable since
70% of doctors are now using EHRs to some extent and 70% to 80% of the
population has household computers.

5)It saves 6 to 8 minutes in each
patient encounter because doctors can getto the root of the problem immediately.

6)It minimizes malpractice risks
because patients understand their problem is being considered fully.

7)It gives the physicians the
framework and the data for submitting a claim for a comprehensiveexamination.

The Health Reform Maze

Buy the Book

Book Description: In this first book in a series of four, Richard L. Reece, MD. provides a unique view of the roll out, and run up, of the Affordable Care Act. Reece shows in this book the progress and facets of ObamaCare's marketers and messengers, as the day approached for the launch of health insurance exchanges - the single most public and problematic portion of the new law. This is a must read for anyone who wants to chronicle this attempt to organize more than one-sixth of the U.S. economy by adding layers of federal government control and regulations.

Reece has been writing about U.S. health care for more than 45 years. His knowledge and experience, added to his keen intellect and gift of subtle humor, make this book a valuable part of anyone's collection.